Close the treatment gap for Cancer in Goa

A simple method to remember the danger signs of cancer is to think of the word CAUTION. It stands for:

C-Change in Bowel or bladder habits

A-A lesion that does not heal

U-Unusual bleeding or discharge and unexplained weight loss

T-Thickening or Lump (breast, testicle, etc)

I-Indigestion or difficulty Swallowing

O-Obvious changes in a wart or mole

N-Nagging cough or persistent hoarseness

I would also like to caution that though these signs can alert you of cancer; the presence of these signs does not mean you have Cancer. Please visit your doctor and seek appropriate help. Cancer survival does depend on the cancer type and ranges from 98% in Testicular cancer to 1% in Pancreatic cancer. In the developed countries more people survive cancer than die of cancer.

The disease is ruthless and spares no one. Let us focus on the Prevention and early detection of Cancer. Let us all be part of the Cancer awareness movement and send a clear message of hope that together we are tougher than Cancer.

What exactly is cancer?

Cancer refers to a group of diseases where cells grow uncontrollably and go beyond their boundaries and later invade other organs - we refer to this as metastasis. It arises from the transformation of normal cells into tumour cells that progresses from a precancerous lesion to a malignant tumour. It can affect several organs or tissue in the body.

What is the magnitude of the problem?

According to official figures, the annual cancer incidence in India increased from 14,26,447 in 2021 to 14,61,427 in 2022. The estimated mortality due to cancer has also increased from 7,89,202 in 2021 to 8,08,558 in 2022. The actual cases may be much more. Cancer has caused 10 million deaths worldwide in the year 2020 alone….and the other big ‘C’- COVID-19 only made matters worse concerning cancer care. I recollect how it was a nightmare for some of our patients who had cancer and were on chemotherapy during the raging pandemic.

With 10 million deaths in 2020 alone, Cancer is a leading cause of death worldwide (nearly one in six deaths). Tobacco accounts for one-third of deaths from cancer, obesity, alcohol consumption, low fruit and vegetable intake, and lack of physical activity are the common risk factors.

Is there a silver lining for this dark cloud?

Yes, one should not be paranoid about the ‘C’ word- it is not a death sentence. Around 30-50% of cancers can be prevented by avoiding the risk factors and implementing the current evidence-based strategies for prevention. Avoid tobacco, both smoking and smokeless tobacco. Reduce weight, take the recommended vaccines, eat right, stay healthy and be alert with regard to the danger signs of cancer. Cancer-causing infections, such as human papillomavirus (HPV) and hepatitis, are responsible for approximately 30% of cancer cases in low- and lower-middle-income countries and these can be prevented with vaccines.

Many cancers can be cured if detected early and treated effectively, both EARLY and EFFECTIVELY are important.

How can we detect Cancer early?

Cancer in the initial stages often goes unnoticed. Screening is a method by which we evaluate apparently healthy individuals to detect cancer. Several such tests are available such as a PAP smear for cervical cancer, mammography for breast cancer, PSA for prostate cancer, etc.

However, despite knowing all this, people are often hesitant to go for screening for fear of the outcome. Around 50% of breast cancer patients visit their doctor in stage 3 and 15-20% visit in stage 4.

What is Goa’s attempt to close the treatment gap?

The Goa government has taken several steps to make screening facilities available at the health centres and also started the iBreast programme under their Swasth Mahila, Swasth Goa initiative in association with Yuvraj Singh’s YouWeCan foundation. The oncology and other departments at the Goa Medical College are also providing medications and services to people in the State itself. There are several NGOs also working in this sector like Muskaan, Goa Cancer society, Prateek foundation, Caritas, and their CanSurvive initiative to raise Cancer awareness.

Any message on World Cancer Day?

All of us would know someone who is currently fighting, survived, or died of cancer. Our cancer warriors need our support. I remember the days when my mother was battling cancer…her battle became OUR battle…. and we pulled through it together. On World Cancer day, I salute all the cancer warriors in the world. I salute the doctors and nurses involved in cancer care. Together We CAN and We Will close the treatment gap.

(The Author is a Lecturer in the department of Preventive and Social Medicine. He was part of the advisory group for the CanSurvive Cancer Campaign for Caritas Goa and has also been involved in Cancer research)